Usefulness of Hyperventilation Thallium-201 Single Photon Emission Computed Tomography for the Diagnosis of Vasospastic Angina.

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概要

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• To establish a safe and sensitive diagnostic procedure for detecting coronary vasospasm, we utilized 201-thallium myocardial SPECT combined with hyperventilation (HVSPECT) in 29 patients with vasospastic angina (VAP) and 11 controls.Twenty-five of 29 patients with VAP and 5 of 11 controls developed transient perfusion defects on HV-SPECT, resulting in a sensitivity and specificity calculated at 86% and 55%, respectively.Overall accuracy in identifying corresponding vessels with coronary vasospasm was 67%; it was 83%, 75% and 42% for patients with 1, 2 and 3 vessel spasm, respectively. Coronary vasospasm tended to be identified more accurately in the left anterior descending branch and the right coronary artery than in the circumflex branch (75%, 71% and 50%, respectively).The hyperventilation test induced ischemic ECG changes in 11 of 29 patients with VAP, yielding a sensitivity of 38%. Analyzing the washout rate of HV-SPECT in patients with VAP, both the extent and severity scores of patients with ischemic ECG changes were larger than those of patients without. No serious complications occurred during HV-SPECT.In conclusion, HV-SPECT was a safe and sensitive procedure as a primary diagnostic approach for VAR From the results of washout analysis, HV-SPECT could detect more mild myocardial ischemia than could the ECG, and seemed quite useful especially for detecting coronary vasospasm accompanied by minimal ischemic ECG changes.

• International Heart Journal刊行会の論文

著者

• Iida Kaname

  Cardiovascular Division Department Of Internal Medicine Institute Of Clinical Medicine The Universit

• Watanabe Shigeyuki

  Cardiovascular Division Graduate School Of Comprehensive Human Sciences University Of Tsukuba

• Sugishita Yasuro

  Cardiovascular Division Department Of Internal Medicine And Department Of Gynecology And Obstetrics

• Yamanouchi Takayoshi

  Cardiovascular Division Institute Of Clinical Medicine Graduate School Of Comprehensive Human Scienc

• Ajisaka Ryuichi

  Cardiovascular Division Department Of Internal Medicine Institute Of Clinical Medicine The Universit

• Masuoka Takeshi

  Cardiovascular Division Department Of Internal Medicine Institute Of Clinical Medicine

• IIDA Kaname

  Cardiovascular Division, Department of Internal Medicine, and Department of Radiology, Institute of Clinical Medicine, University of Tsukuba

• SATO Motohiro

  Cardiovascular Division, Department of Internal Medicine, and Department of Radiology, Institute of Clinical Medicine, University of Tsukuba

• TAKEDA Tohru

  Cardiovascular Division, Department of Internal Medicine, and Department of Radiology, Institute of Clinical Medicine, University of Tsukuba

• TOYAMA Hinako

  Cardiovascular Division, Department of Internal Medicine, and Department of Radiology, Institute of Clinical Medicine, University of Tsukuba

• ISHIKAWA Nobuyoshi

  Cardiovascular Division, Department of Internal Medicine, and Department of Radiology, Institute of Clinical Medicine, University of Tsukuba

• ITAI Yuji

  Cardiovascular Division, Department of Internal Medicine, and Department of Radiology, Institute of Clinical Medicine, University of Tsukuba

• MASUOKA Takeshi

  Cardiovascular Division, Department of Internal Medicine, and Department of Radiology, Institute of Clinical Medicine, University of Tsukuba

• YAMANOUCHI Takayoshi

  Cardiovascular Division, Department of Internal Medicine, and Department of Radiology, Institute of Clinical Medicine, University of Tsukuba

• SUGISHITA Yasuro

  Cardiovascular Division, Department of Internal Medicine, and Department of Radiology, Institute of Clinical Medicine, University of Tsukuba

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